The road to recovery
Getting better from an eating disorder may be thought of as involving three tasks. These need to be tackled whether or not the sufferer recovers with treatment or, as sometimes happens, with little or no help from professionals. The tasks remain the same. It may be useful to outline these tasks before going on to discuss the treatments which may help the sufferer to address them.
Although the three tasks will be presented separately, they are closely linked. For someone trying to recover they will be all mixed up together. Furthermore, all three must be achieved if true recovery is to take place.
RESTORE A HEALTHY WEIGHT AND PATTERN OF EATING
The first task is for the sufferer to regain a sustainable and healthy body weight and pattern of eating. This involves the person giving up undue eating restraint and allowing her weight to find a level where it can naturally regulate itself. She must, as it were, rediscover a sense of natural control – an ‘automatic pilot’. The sufferer needs to learn to trust the regulatory mechanisms of the body rather than fighting them all of the time. In practice, this involves eating regular meals of sufficient size. Carbohydrate may be especially important in restoring appropriate regulation of eating. Although easy to describe, this task may be very difficult for the sufferer to allow herself to do. The role of those helping someone to achieve this goal is to try to promote a sense of sufficient safety and security. This may involve trying to help the individual to feel that her eating will not run out of control once she starts. It does not involve simply pushing her to eat.
DISENTANGLE IDEAS OF WEIGHT FROM WIDER PERSONAL ISSUES
The second task is to disentangle ideas about weight and eating control from wider personal issues.
This is not only difficult to do but even difficult to think about in precise terms. Within our society some overlap and entanglement of such issues with self-esteem and so on is common. However, for women with eating disorders they become very mixed up. If she is to recover the sufferer must examine and then challenge the particular ideas that have come to determine so much of her behaviour. These could include ideas that to be thin is to be happy and successful or that if she is not vigilant her weight will go up and up in an uncontrolled fashion. She has to discover for herself the problems and limitations of such ideas. This task seems to involve thinking and perhaps talking. The person may also need to test out in practice the apparent truth or otherwise of some of these cherished ideas.
FACE PERSONAL ISSUES
Confronting particular personal issues which are relevant and problematic to each sufferer is crucial to recovery. And the problems that need to be tackled are likely to be as varied as the people who develop eating disorders.
If a woman with an eating disorder could magically accomplish the first and second tasks, she would still be confronted with all the problems and self-doubts that had previously been tangled up with weight and eating. Furthermore, months or years of such entanglement may have brought changes that are themselves problematic.
The third task then is to get life on the move again. This is often spoken of as getting life ‘sorted out’. However, most people’s lives are never truly sorted out, but involve a progression from one issue or problem to the next. Living entirely happily ever afterwards is for fairy tales. So a woman with an eating disorder must learn to move away from the behaviour in which she is trapped, going round and round in circles with the same problems. She must move on. In this respect it may be useful to consider once more the fictional accounts of the lives of Heather and Susan which were given earlier. Real lives are certainly no less complex.
